Symptoms of Parkinson’s Disease
The symptoms of Parkinson’s disease vary from person to person. No two people with Parkinson’s disease experience symptoms in exactly the same way or have the same progression of symptoms. There are many symptoms of Parkinson’s disease, including both movement and non-movement symptoms.
Movement Symptoms
There are four primary movement symptoms. It is not required that someone with Parkinson’s disease experience all four symptoms.
- Tremor (shaking), often at rest
- Slowness of movement, called bradykinesia
- Rigidity or muscle stiffness
- Postural instability of balance problems
Despite tremors being the most well-known Parkinson’s symptom, about 25% of people diagnosed with Parkinson’s do not experience a tremor.
Early in the progression of Parkinson’s disease, movement symptoms are generally only on one side of the body and are not yet disabling. As the disease progresses, movement symptoms eventually develop on both sides of the body, and gradually become more disabling. The progression of Parkinson’s disease can take many years and even decades. No two people experience the progression of the symptoms in the same way.
Non-movement Symptoms
While most people think of Parkinson’s disease in terms of movement, there are dozens of non-movement symptoms. These symptoms may start developing years before someone is diagnosed with Parkinson’s disease. It is important to share these symptoms with your doctor. Some non-movement symptoms include:
- Problems with sleep, including REM Sleep Disorder
- Mood changes, including depression, anxiety, and apathy (loss of interest)
- Digestive issues including constipation
- A drop in blood pressure when standing, called orthostatic hypotension
- Lack of facial expression
- Speech and swallowing issues
- Fatigue
- Pain
- Brain Fog
- Cognitive difficultues
- Hallucinations and delusions
- Dementia
Many people describe non-movement symptoms as being more debilitating than the movement symptoms. There are many more non-movement symptoms that can be attributed to Parkinson’s disease. At the same time, these symptoms can also be caused by other medical conditions. It is important to talk to your doctor about all of your movement and non-movement symptoms so they can see the full picture.
Diagnosing Parkinson's Disease
Diagnosing Parkinson’s disease isn’t as easy as running a test. There isn’t one test that can tell a doctor that someone has Parkinson’s disease. A diagnosis is made using a variety of observations and evaluations.
Many people start with a visit to their primary care doctor. While primary care doctors are trained to treat many different ailments, if you or they suspect Parkinson’s disease, you will want to ask to be referred to a neurologist. Even in the field of neurology, there are many different specialities. The kind of neurologist who has the most training and experience treating Parkinson’s disease is called a Movement Disorder Specialist, and these are usually the best neurologists to treat Parkinson’s disease.
A diagnosis is made by:
- Reviewing your medical history
- Going over your current symptoms
- A neurological exam
To be diagnosed with Parkinson’s disease, bradykinesia (slowness of movement) plus at least one other symptom must be present. Sometimes, additional tests might be ordered to help give your doctor more information. These tests might include:
- DaTscan: This is a specialized nuclear imaging test. A drug is injected into you that attaches to your dopamine transmitting proteins. If the test shows a diminished level of this protein, it implies that your brain is producing less dopamine. This test can be used to rule out essential tremor, since in this condition, the dopamine levels are not diminished. However, it cannot be used to specifically diagnose Parkinson’s disease because there are other conditions that also cause someone to have less dopamine.
- Skin Biopsy: This is a test that can identify misfolded alpha-synuclein protein which is found in most people with Parkinson’s. However, it is also found in other conditions, so it cannot be used to definitely diagnose Parkinson’s disease.
- MRI: This imaging test can be ordered to rule out other conditions that may cause similar symptoms to Parkinson’s disease.
If a doctor suspects you have Parkinson’s disease, they may have you start on Parkinson’s medications, specifically levodopa, to see if your symptoms improve. Most people will experience an improvement of symptoms. However, if someone has a different movement disorder or neurological condition, this medication will not help, and for some, may even make their symptoms worse.
Young Onset Parkinson's Disease
While Parkinson’s disease is primarily diagnosed later in life, a small percentage of younger people can be affected. Young-onset Parkinson’s disease is diagnosed when a person receiving the diagnosis is under the age of 50.
You are Not Alone
Learning that you have Parkinson’s disease can feel overwhelming. You may wonder and have fears about your future. For other people, a diagnosis can be a relief because they finally understand what’s causing their symptoms.
The Parkinson Association of the Carolinas (PAC) is here to provide you with support, education, and resources to help you every step of the way. Contact PAC so you have what you need to manage your Parkinson’s and live the best you can today. We are here for you.